Of course, putting those medical billing and coding process steps in place can be difficult. It’s even more difficult if you don’t know what an acceptable collection ratio is or how frequently you should bill patients in the first place. Make use of these medical coding tips and best billing practices to guide your operations!
1. Create Patient-Friendly Medical Billing Statements
Although medical practices and hospitals are aware of the complexities of the medical billing process, patients are likely to be perplexed. Industry expectations have shifted in such a way that providers must now take a patient-centered approach to this process, so it’s more important than ever to educate yourself on how to remain accessible.
2. Maintain a clean claim rate of at least 95%.
The clean claim ratio of your medical practice is the average number of claims paid on the first submission. In an ideal world, every provider would like to achieve a percentage greater than 95 percent, but the meaning behind the number is what truly matters. The higher your clean claim rate, the less time your staff will spend attempting to identify denial reasons, coordinate payments, and re-submit claims.
3. Don’t Ignore Payer Reimbursements Analysis
Many medical practices place too much trust in payers to reimburse them in full for every claim they submit. Regrettably, this is not always the case. Underpayments are more common than you may believe. Devoting resources to analyzing payment accuracy will reduce revenue loss while providing valuable insight into your practice’s revenue management cycle data.
4. Take Control of Your Accounts Receivable
How frequently do you keep track of your receivables? Do you find yourself pressed for time to respond to a denied claim? Perhaps you should reconsider how you handle contracts and receivables. Coding changes occur quickly in the healthcare industry, and there is no better time to prepare for potential issues.
5. Return to the Fundamentals of Revenue Cycle Management
Are you brand new to revenue cycle management? The first step is to have a consistent cash flow. Even if you’re well-versed in the complexities of medical billing and coding, it’s always a good idea to review your basic best practices to ensure you haven’t deviated from the path.
6. Submit Complete and Accurate Claims
Making sure your medical billing is correct the first time you submit it can save you the time and effort of editing and resubmitting incorrect claims. It is estimated that up to 80% of medical bills contain errors, resulting in weeks of editing, resubmission, and provider’s not receiving payment. Filling out claims correctly and avoiding common errors, such as incorrect patient or insurance information and duplicate claims, can help your medical practice have an efficient medical billing process.
7. Maintain Knowledge of Medical Billing Rules and Regulations
It is critical to be aware of the current medical billing rules in order to ensure best practices in medical billing and coding. Because regulations are constantly changing, staying informed can result in a more efficient process that avoids rejections and medical billing edits. Failure to stay current on medical billing rules can have a direct impact on the cash flow of your medical practice.
8. Always look for opportunities to improve.
Finding ways to improve will continue to help your healthcare practice grow. Because the healthcare industry is constantly changing, looking for ways to optimize the medical billing process on a consistent basis will help to maximize revenue. Aside from staying up to date on current medical billing regulations, tracking performance is critical for identifying inefficiencies and optimizing efficiency. Key performance indicators (KPIs) can help measure the accuracy and efficiency of previous performances and identify areas for improvement.
5 Medical Billing Tips for Your Healthcare Practice
- File claims on a daily basis
- Collect copayments at the point of service.
- Verify and update the patient’s insurance
- Keep track of unpaid claims and follow up on them.
- Make EOBs your friends
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